<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Source')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-source" data-rule="required" data-source="/admin/base/source/index" data-primary-key="id" data-field="name"  data-params='{"custom[type]":"1"}'  class="form-control selectpage" name="row[source]" type="text" value="{$row.source}">
     
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Sheng')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sheng" class="form-control form-control" name="row[sheng]" type="number" value="{$row.sheng}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Shi')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-shi" class="form-control form-control" name="row[shi]" type="number" value="{$row.shi}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Xian')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-xian" class="form-control form-control" name="row[xian]" type="number" value="{$row.xian}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Apply_1')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-apply_1" class="form-control form-control" name="row[apply_1]" type="text" value="{$row.apply_1}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Apply_2')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-apply_2" class="form-control form-control" name="row[apply_2]" type="text" value="{$row.apply_2}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Apply_3')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-apply_3" class="form-control form-control" name="row[apply_3]" type="text" value="{$row.apply_3}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" class="form-control form-control" name="row[name]" type="text" value="{$row.name}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Tel')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-tel" class="form-control form-control" name="row[tel]" type="text" value="{$row.tel}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Weixin')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-weixin" class="form-control form-control" name="row[weixin]" type="text" value="{$row.weixin}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Email')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-email" class="form-control form-control" name="row[email]" type="text" value="{$row.email}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Info')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-info" class="form-control  form-control" rows="5" name="row[info]" cols="50">{$row.info}</textarea>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
